Background: Several epileptic patients give no response to the usual line of treatment, which represents 1/5 of epileptic patients and is known as drug-resistant epilepsy (DRE). DRE is often accompanied by impaired intellectual functions, psychiatric co-morbidities, physical damage, and low quality of life (QoL). Objective: This study aimed to assess the predictive factors for early identification of refractory seizures. Patients and Methods: This was a cross-section study conducted during a period of one year at Emergency Department (ED), Faculty of Medicine, Mansoura University. We comprised cases with diagnosis of refractory epilepsy on a total of 80 patients with refractory seizures [at least 2 potentially effective anti-epileptic drugs (AEDs) whatever mono or combined in maximally tolerated dose]. Results: Of the studied cases, 62.5% were females. There was a significant difference in cases with refractory epilepsy as regard seizures types with higher frequency of mixed and focal seizures. There was no statistically significant difference recorded regarding the previous history of status epilepticus (SE). Mixed seizures were significantly increased among cases with refractory epilepsy. The presence of positive family history, positive history of febrile seizures, associated psychiatric disorders and younger age at disease onset increase risk of refractory epilepsy. Conclusion: The main predictors of development of DRE were high initial seizures frequency, positive family history, febrile seizures, associated psychiatric disorders and younger age at disease onset.
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